MEDICAL RECORDS AND PRIVACY PRACTICES

1.) Uses and Disclosures: All providers of Life Coast Community Health Center are permitted by law to disclose the minimum necessary personal health information of each patient to carry out treatment, payment, and healthcare operations of the facility. For treatment purposes, such disclosures may be made to physicians, and other healthcare providers as necessary to effectuate the appropriate treatment and care of patients. Personal health information may be disclosed to the government or other third-party payers for the purpose of obtaining payment for services provided. The facility may also use personal health information

to carry out day to day operations such as scheduling, appointment, reminders, and quality review.

2.) Required Authorizations: The facility will not disclose any patient’s personal health information for

any purpose aside from payment, treatment, and healthcare operations, without the patient’s authorization

to disclose such. Upon request for such authorization, patient shall have the right to refuse and/or revoke any disclosure of patient’s personal health information.

3.) Privacy Compliance: In accordance with the privacy regulations promulgated under the Health Insurance Portability and Accountability Act, 45 CFR Parts 160 and 164 (“The Privacy Regulations”), the facility has adopted privacy policies regarding usage of patients’ personal health information. The facility is

in compliance with the Privacy Regulations and all other laws and regulations regarding patients’ right to privacy.

4.) Additional Information: For additional information regarding the facility’s privacy policy or for a copy of this notice, please contact our office. The facility reserves the right to change this notice and to make the revised and changed notice effective for medical information that the facility already has about you, as well as any information the facility receives in the future.

The notice will contain the effective date.

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